HELENA — In Montana’s U.S. Senate race, perhaps no other issue has both drawn a sharper contrast between the candidates and stirred emotions more than health care.
Republican U.S. Sen. Steve Daines and his Democratic challenger, Gov. Steve Bullock disagree on everything from the Affordable Care Act to prescription drug prices – and both sides have spent millions of dollars on ads, blasting the other on their respective positions.
“Steve Bullock isn’t telling the truth,” Daines said in a recent campaign ad. “He’s using my vote to fix the Obamacare mess to lie to you about pre-existing conditions. … I’ve always fought to protect Montanans with pre-existing conditions.”
Bullock and his campaign say Daines and fellow Republicans are distorting his positions and incorrectly saying Bullock supports “government-run health care.”
A big part of the fight centers on the Affordable Care Act, the 2010 health-reform law known as “Obamacare.”
Daines has voted several times as a congressman and U.S. senator to repeal the law, which, among other things, banned health insurers from charging higher prices to people with pre-existing health conditions, created Medicaid expansion, which now covers almost 90,000 low-income Montanan, and allowed young adults to stay on their parents’ policy until they are 26.
He also told MTN News he supports the Republican-led lawsuit to invalidate the ACA, that is before the U.S. Supreme Court on Nov. 10.
When asked how he has “always fought” to protect Montanans with pre-existing conditions, while trying to get rid of the law that created those protections, Daines points to a separate GOP-sponsored bill that he supports and says would maintain those protections.
“There are other solutions that we can put in place here without doubling health-care premiums,” he said.
That bill, however, has not passed – and Bullock said it’s not needed, if the ACA is maintained.
“That’s sort of what Washington, D.C. does – they throw in a bill that’s going to go nowhere, saying it’s going to make a meaningful difference in people’s lives,” Bullock said. “We’ve (made) a meaningful difference in people’s lives, with Medicaid expansion and with the ACA …
“And every step of the way, Steve Daines has tried to take that away. And there isn’t something in the background, ready for replacement, if the Supreme Court rules otherwise.”
Daines blasts the ACA as a strictly partisan approach and says it has “more than doubled” health-care premiums for Montanans and caused 20,000 Montanans to lose their health insurance.
“There are other solutions that we can put in place here without doubling health-care premiums, which we’ve seen here in Montana,” he said. “The question that doesn’t get asked is, what do we do to replace the ACA? There’s got to be a bipartisan solution on this.”
The 20,000 Montanans who “lost” their health insurance are those who had to buy a different policy in 2013, when the ACA took effect and required policies on the individual market to include a minimum list of “essential benefits.”
At the time, health insurers said they would provide their customers other options that complied with the law, that may or may not cost more.
The “doubling” of premiums refers to 2017 federal study that said individual, non-group policies purchased on the ACA exchange in Montana – about 5 percent of the total health insurance market – increased 133 percent from 2013, when Obamacare took effect.
The study doesn’t mention that the vast majority of those customers had their premiums subsidized by the ACA. It also doesn’t mention that in 2015, Congress defunded what are called “risk corridor payments,” meant to offset some of those policies’ costs and keep premiums lower – a move that led to substantial increases in price the following year. Daines voted for the bill that got rid of those payments.
Bullock said the bulk of the ACA provisions helped expand affordable coverage for thousands of Montana, from Medicaid expansion to subsidized premiums on the individual market to prescription-drug benefits for seniors.
“The whole time Daines has been in Washington, he’s been trying to take that health care away from us and strip away the (protections) for pre-existing conditions and undermine Medicaid,” he said. “I support building on what we have, not tearing it all down.”
Part of that “build” is Bullock’s support for a “public option,” which would be a government-financed health insurer to compete with private insurers.
The insurance industry opposes the public option and Republican-connected groups have been attacking Bullock as a supporter of “government-controlled health care,” saying the public option is just a ruse to create a government takeover of health care that will harm rural hospitals.
Bullock scoffs at these attacks, calling them a gross distortion of reality.
“It’s not going to hurt hospitals, first of all, as long as you have reimbursement rates,” he says. “What we need to do is ensure there is adequate competition in the marketplace. Someone could buy into a public option and look at that as one of their choices. … It’s actually going to be yet another option for consumer choice.”
On prescription drug prices, Daines points to his vote, 16 months ago, for a bill that would cap some drug prices. It’s projected to save consumers $100 billion over 10 years. However, that bill has yet to have a floor vote in the Senate.
“It was something that big Pharma was fighting against us on,” Daines says. “But we passed that out of the Finance Committee. We need now to get an up-or-down vote on that on the floor of the Senate, and I think we’ll have a chance to get that done after the election.”
Bullock said the bill doesn’t go far enough, and didn’t include what he consider a vital step toward reducing drug prices: Allowing the federal government to negotiate directly with the industry on prices for Medicare, a huge part of the market.
“Costco can negotiate prescription drug prices; the Department of Defense can negotiate prescription drug prices. But it is a crime for the federal government, the largest purchaser, through Medicare to do so. …
“We shouldn’t be paying these drug companies whatever they say we have to pay. That’s not how a free market works. And Steve Daines stands in the way of that.”